Parkview Senior Psychiatric Program

Although seniors make up only 12% of the population, they are prescribed about 30% of all drugs. Not only are they prescribed more drugs, but these drugs may also have a greater effect on them. It has been estimated that over 20% of Medicare payments are related to hospitalizations caused by smoking, drinking alcohol or abusing prescription drugs.Elders often are prescribed tranquilizers, anti-anxiety drugs and other medications that compound the effects of alcohol. These drugs can magnify the effects of a few drinks and lead to acute intoxication. A senior who has relied on a prescribed medication for months or years to help with a medical condition may be reluctant to reduce or eliminate that medication from his or her maintenance regimen. Elders who have memory difficulties and abuse alcohol can easily lose track of their medication schedules, leading to unintentional overdoses.The best place to begin helping is often with the elder's primary-care physician. At the very least, making the doctor aware that you feel there may be a problem with alcohol or drugs can minimize the risk of a dangerous drug interaction. As with anyone with a longstanding addiction problem, the safest place to begin treatment is under medical supervision. Taking away someone's alcohol or pills suddenly can have serious and even fatal consequences. Sudden withdrawal from alcohol or some drugs can lead to hallucinations, convulsions and death. It is important that any inpatient treatment take place in a program with extensive experience in treating seniors. The elderly should look for a program or group meeting that includes seniors with similar backgrounds. Although treatment is more likely to be successful for those who began drinking later in life, it can work and is worth attempting with any individual with an addiction problem.Editor's Note: This article was excerpted from one prepared by David Brown, PhD, LPC, LAC and was submitted by Parkview Medical Hospital. For further information they can be reached at 719-584-4000.Author: David Brown

Disordered sleep is common. Chronic insomnia (insomnia for more than 5 nights a week for more than 6 months) affects 14% of the worlds population. Sleep Apnea, the most physiologically disruptive and dangerous of sleep disorders, affects 9% of women and 24% of men. Apnea induces daytime sleepiness in some individuals and leads to a higher frequency of automobile and occupational accidents. High blood pressure is present in 80% of individuals with significant sleep apnea. Heart attacks and strokes sometimes resulting in death are significantly more common in individuals with sleep apnea. New data suggests that sleep apnea is associated with hearth rhythm disturbances and diabetes. Our sleep does not improve with age. Insomnia, sleep apnea, and restless leg syndrome all become more common as we get older. The only sleep variable that increases for the elderly is time awake in bed.With ageing, we are more likely to require medications and more likely to suffer side effects from those medications. Daytime sleepiness is perhaps the most common side effect of both prescription and over-the-counter medications. Many medications used to treat insomnia are long-acting and induce next day sleepiness after nighttime use. Such medications include long-acting benzodiazepines like valium, sedating anti-depressants, and over-the-counter sleeping medications with sedating anti-histamines as an active ingredient, such as Benadryl and Tylenol-PM. In seniors, these over-the-counter medications have been shown to induce confusion as well as an increased risk of accidents and falls. They can also be more dangerous than newer prescription medications for sleep.The safest option for the treatment of insomnia is cognitive-behavioral therapy, an approach available through most sleep physicians that has been shown to have excellent and long-term results. Sleep apnea is best treated with a C-pap system which blows air into the nostrils to hold the airway open during sleep. When tolerated, this treatment has almost no negative side effects. When regularly using C-pap, individuals with sleep apnea live longer and function better.Editors note: This article was submitted by J.F. Pagel, MD at the Sleep Center of Southern Colorado at Parkview Medical Center. For more information he can be reached at (719) 584-4976